How Does the Public Evaluate Vaccines for Low-Incidence, Severe-Outcome Diseases? A General-Population Choice Experiment.

IF 3.4 3区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Patient-Patient Centered Outcomes Research Pub Date : 2023-03-01 DOI:10.1007/s40271-022-00602-x

F Reed Johnson, Angelyn Fairchild, Dale Whittington, Amit K Srivastava, Juan Marcos Gonzalez, Liping Huan

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Abstract

Background: Because immunizing large numbers of healthy people could be required to reduce a relatively small number of infections, disease incidence has a large impact on cost effectiveness, even if the infection is associated with very serious health outcomes. In addition to cost effectiveness, the US Advisory Committee on Immunization Practices requires evidence of stakeholders' values and preferences to help inform vaccine recommendations. This study quantified general-population preferences for vaccine trade-offs among disease severity, disease incidence, and other vaccine features.

Methods: We developed a best-practice discrete choice experiment survey and administered it to 1185 parents of children aged 12-23 years and 1203 young adults aged 18-25 years from a national opt-in consumer panel. The data were analyzed using exploded-logit latent-class analysis.

Results: Latent-class analysis identified two classes with similar relative-importance weights in both samples. One of the two classes represented about half the samples and had preferences consistent with well-structured, logically ordered, and acceptably precise stated-preference utility. Preferences for the other half of the samples were poorly defined over the ranges of vaccine and disease attributes evaluated. Both parents and young adults in the first class evaluated protection from a disease with 1 in 100 incidence and full recovery at home as having statistically the same preference utility as a disease with 1 in 1 million incidence requiring hospitalization and resulting in permanent deafness.

Conclusions: The results suggest that vaccines that protect against low-incidence, severe-outcome diseases, provide 'peace of mind' benefits not captured by standard health-outcome metrics. The fact that half the respondents had poorly defined vaccine preferences is a reminder of the challenges of implementing patient-centric vaccine decision making.

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公众如何评价低发病率、严重结局疾病的疫苗?一般人口选择实验。

背景:为了减少相对较少的感染，可能需要对大量健康人群进行免疫接种，因此，即使感染与非常严重的健康后果有关，疾病发生率也会对成本效益产生很大影响。除了成本效益外，美国免疫实践咨询委员会还需要利益攸关方的价值观和偏好的证据，以帮助提供疫苗建议。本研究量化了一般人群在疾病严重程度、疾病发生率和其他疫苗特征之间对疫苗权衡的偏好。方法:我们开发了一项最佳实践离散选择实验调查，并对来自全国可选消费者小组的1185名12-23岁儿童的父母和1203名18-25岁的年轻人进行了调查。采用爆炸-logit潜类分析对数据进行分析。结果:潜在类分析确定了两个类在两个样本中具有相似的相对重要性权重。其中一个类别代表了大约一半的样本，其偏好与结构良好、逻辑有序、可接受的精确状态偏好效用一致。在评估的疫苗和疾病属性范围内，对另一半样本的偏好定义不清。第一类的父母和年轻人都认为，预防一种发病率为百分之一并在家中完全康复的疾病，在统计上与发病率为百万分之一、需要住院治疗并导致永久性耳聋的疾病具有相同的偏好效用。结论:研究结果表明，预防低发病率、严重结局疾病的疫苗提供了标准健康结局指标无法捕捉到的“安心”益处。一半的答复者对疫苗的偏好定义不明确，这一事实提醒人们注意实施以患者为中心的疫苗决策所面临的挑战。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Patient-Patient Centered Outcomes Research HEALTH CARE SCIENCES & SERVICES-

CiteScore

6.60

自引率

8.30%

发文量

审稿时长

>12 weeks

期刊介绍： The Patient provides a venue for scientifically rigorous, timely, and relevant research to promote the development, evaluation and implementation of therapies, technologies, and innovations that will enhance the patient experience. It is an international forum for research that advances and/or applies qualitative or quantitative methods to promote the generation, synthesis, or interpretation of evidence. The journal has specific interest in receiving original research, reviews and commentaries related to qualitative and mixed methods research, stated-preference methods, patient reported outcomes, and shared decision making. Advances in regulatory science, patient-focused drug development, patient-centered benefit-risk and health technology assessment will also be considered. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in The Patient may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances. All manuscripts are subject to peer review by international experts.